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WHAT THE WOMEN OF ILLINOIS OUGHT TO KNOW AND 
OUGHT TO DO ABOUT THE QUESTION 
OF SOCIAL HYGIENE 


A Report Submitted by the Committee 
Appointed at the Request of the Joint Con¬ 
ference of the Women’s Clubs of Chicago. 








WHAT THE WOMEN OF ILLINOIS OUGHT TO KNOW AND 
OUGHT TO DO ABOUT THE QUESTION 
OF SOCIAL HYGIENE 


A REPORT SUBMITTED BY THE COMMITTEE APPOINTED AT 
THE REQUEST OF THE JOINT CONFERENCE OF 
THE WOMEN’S CLUBS OF CHICAGO 


Owing to many requests for information, on the part of club women, 
concerning the best methods of fighting prostitution and combating vene¬ 
real disease, the presidents of the Woman s City Club , the Illinois League 
of Women Voters, and the Chicago Woman's Club called together on 
October 27, 1922, representatives of about one hundred organisations 
of women. At this meeting, attended by representatives of about half of 
these clubs, a Committee was appointed to set forth certain standards and 
to formulate a program for which women could work and fight if neces¬ 
sary. The following Report submitted by the Committee is intended to 
give information concerning the present situation in Illinois; to remove 
some misconceptions; and to serve as a basis for the discussion of present 
needs and policies. The report also offers suggestions to women's organi¬ 
zations in Chicago and throughout the state as to certain definite and 
practical ways in which they may assist in abolishing prostitution and its 
terrible consequences. We commend this report to the attention of all 
women who are interested in preserving the sanctity of their homes, the 
welfare of their children, and the honor of the city and their state. 

Louise de Koven Bowen, 

President, Woman’s City Club 

Flora Sylvester Cheney, 

President, Illinois League of Women Voters 

Grace E. Temple, 

President, Chicago Woman’s Club 

REPORT OF THE COMMITTEE 

Your Committee, after a careful consideration of the questions raised 
at the Joint Club Conference, decided to submit a series of suggestions 
which, it is hoped, different clubs in the city and in the state may be 
willing to consider. We submit also a brief review of our present 
methods of dealing with various social hygiene questions in Illinois, since 
such a review seems necessary as a basis for any discussion of present 
or future policies. These measures in Illinois fall into two groups: first, 
those affecting all classes and both sexes; and, second, those relating 
primarily to the prostitute class. In the first group, in which noticeable 
and very commendable progress has been made in recent years, are such 
measures as (1) the provision of free clinics for all persons suffering 


3 




from venereal disease; (2) the provision of hospital facilities for those 
who need them; ; and (3) moral education for the youth of the com¬ 
munity both in the schools and at home. A brief statement is presented 
of the progress made in Illinois in each of these fields. 

GENERAL MEASURES RELATING TO PUBLIC HEALTH 
AND EDUCATION 

1. Clinical facilities for the venereal disease .—That the best curative 
treatment should be available to all persons of all classes suffering from 
these terrible diseases will not be questioned. Such clinics should be 
free, and attendance should be voluntary, since compulsion at present 
cannot and will not be applied equally to both men and women. As 
women of Illinois we commend the State and City Health Departments 
for the efforts they have been making in establishing free clinics in 
Chicago and in other parts of the state. A Division of Social Hygiene 
was first created in our State Department of Health in July, 1918, after 
a grant of $66,000 for this purpose had been made by the federal gov¬ 
ernment. Later the Division was maintained on the basis of joint 
contributions from the state and the federal government until in 1921, 
when federal aid was withdrawn. Since then the Division has been 
entirely supported by a state appropriation of $100,000 annually. The 
Division made a beginning in 1919 with 6 clinics, which treated 3,926 
cases; and the number had been increased until in the year ending June 
30, 1922, eighteen clinics treated 44,475’ cases, including 28,504 men and 
15,971 women. In Chicago alone there are five Health Department clinics, 
which last year gave 44,407 treatments. These free public clinics are in 
addition to those in hospitals which are maintained on a private basis. 
The public clinics are supported upon a subsidy basis, the State Health 
Department and the local community sharing the expenses jointly. 

A new and increased appropriation for developing this work will 
be needed next year, and we urge the women of the state to support 
the demand for an appropriation when the state legislature meets. 
Attendance at these clinics is voluntary and a sufficient appropriation 
should be secured to provide such facilities as will tend to attract and 
hold patients. We believe, however, that women patients at these clinics 
should be treated by competent women physicians. If such physicians 
are not available, a nurse should always be present in clinics where women 
are being treated. A woman social service worker should also be attached 
to each clinic. Such a worker could do much for the women who are 
suffering, not only to persuade them to continue treatments until phys¬ 
ically cured, but also to assist those of the immoral class to re-establish 
themselves in proper occupations. It is clear that there is a moral as 
well as a medical problem here and that medical treatment alone, however 
skillful, will never be completely successful. 

Have you one of these clinics in your community? Are there sep¬ 
arate waiting rooms for men and women? Is there a woman there—a 
woman physician, a nurse, or a social worker—to attend and supervise 
and help the women who come to it? 

2. Hospital facilities .—While we appreciate the fact that the state 
and city departments of health have shown a genuine desire to provide 
necessary hospital care for those in need, much more ample resources 


4 


should be available. The women of the state, in particular, are interested 
in certain aspects of hospital provision. Such hospitals should, in the 
first place, be on a voluntary basis. It is unjust and futile to compel a 
handful of persons to remain in a hospital under detention while thou¬ 
sands of other persons with the same infections are left at home and at 
work. It is important also that such hospitals should insure privacy for 
individual patients at each step, during examination, during diagnosis, 
and during treatment. A competent woman physician should have charge 
of the women and girl patients. Careful selection should be made of 
those who are to occupy the same room; for moral contagion as well as 
physical contagion must be prevented. Patients should not be left in 
idleness; and for those whose own experience or. background or friends 
do not provide it, institutional occupations should be developed. 

And finally, a social service department is all important. Little good 
is done, after all, if such persons are cured only to go back again to the 
hideous business of re-infection. A competent social worker could help 
many of these girls and women to find their way out of the tragic lives 
of degradation into which they have fallen. 

3. As regards education .—In the city of Chicago we are glad to 
remember that our late leader, Mrs. Ella Flagg Young, attempted to 
introduce into the public school system the work of education in this 
field. The present Superintendent of Schools, Mr. Mortenson, has also 
shown a desire to advance this work. With due consideration of all 
the difficulties involved, we urge its extension as rapidly as public opinion 
can be prepared to accept it. Recent suggestions concerning the respon¬ 
sibilities of parents point to the importance of including this among the 
subjects that should be systematically and adequately presented before 
mothers’ clubs, parent-teacher associations, and other organizations of 
women. 

MEASURES AFFECTING THE PROSTITUTE CLASS 

The second group of measures are those which practically deal only 
with the small class of professional prostitutes. There is already a con¬ 
siderable body of legislation on this subject consisting of acts of the legis¬ 
lature and of ordinances of the cities of the state. These statutes and 
ordinances may themselves be said to fall into two groups. In the 
first group are those time-honored and wholesome measures in which 
the community has from time to time declared its desire to abolish the 
whole system of prostitution. In the second group are certain measures 
that indicate a recent and dangerous tendency to legalize and regulate 
prostitution rather than to abolish it. 

Houses of prostitution outlawed in 1845 . —Looking at the measures 
of the first group, we nofe that the first of these measures was passed 
as long ago as 1845 ( Illinois Revised Stahites, chap. 38, sec. 57), when 
the state legislature made it unlawful to keep or maintain or patronize 
these places; and as early as 1874 the legislature ( Illinois Revised Stat¬ 
utes•, chap. 24, sec. 245) put itself on record as declaring that neither the 
corporate authorities nor any board of health should ever be connected 
with the maintenance of such places. In express terms the city authori¬ 
ties were forbidden ever to license or to supervise these outlawed estab¬ 
lishments. Unfortunately the policy of abolition was partially nullified 


5 


in practice by the failure of administrative officials to carry out this 
policy, and the early statutes were at a later date supplemented by a 
series of measures passed both by the state legislature and in Chicago 
by the City Council including such acts as the Injunction and Abatement 
Act, the Pandering Act, etc. (See Illinois Revised Statutes, chap. 38. 
sections 11, 57, 57a-l, 57g, 270; and see also Chicago City Ordinances 
2012, 2014, 2015, 2018, 2019.) 

As women of Illinois we are proud of the fact that our legislature 
at an early date wrote on our statute books the approval of what -may be 
called the American system of abolishing prostitution instead of the 
European plan of tolerating and regulating it. If a doubt exists in the 
mind of any woman in Illinois as to the hideous results of the European 
system of toleration and regulation, we urge her to read the report on 
this subject by Mr. Abraham Flexner ( Prostitution in Europe, Century 
Company). ‘‘Regulation has failed in the past,” wrote Mr. Flexner 
after his careful study of conditions in the principal European cities, 
“even in the opinion of authorities theoretically inclined to believe in it” 
(p. 248). 

Women should demand the enforcement of the “abolitionist” statutes. 
—This Committee urges the organized club women of Illinois to demand 
the vigorous enforcement of all these measures, new and old, which are 
based on the sound policy of abolishing prostitution and its terrible effects 
on public morals and oublic health. We believe on the other hand that 
women should view with alarm certain measures quite recently adopted 
which if pursued may lead to the introduction in our own country of 
certain phases of the dangerous European policy of “toleration.” In this 
class fall such measures as the compulsory examination of women sus¬ 
pected of leading immoral lives, and the compulsory hospitalization of 
such women, “placarding,” etc. In particular we believe the following 
section of a statute passed in 1919 is dangerous to public morals and 
should be repealed: 

DUTY OF JUDGE OR JUSTICE OF THE PEACE WHERE PERSON 
CHARGED WITH CRIME IS SUFFERING FROM COMMUNICABLE VENE¬ 
REAL DISEASE. When it appears to any judge or justice of the peace from 
the evidence or otherwise that any person coming before him on any criminal charge 
may be suffering from any communicable venereal disease, it shall be the duty of such 
judge or justice of the peace to refer such person to the director of such hospital, san¬ 
itarium or clinic, or to such other officer as shall he selected or appointed, for the 
purpose of examining the accused person and if such person be found to be suffering 
from any communicable venereal disease, he or she may by order of the court be 
sent for treatment to a hospital, sanitarium or clinic if any be available and if 
necessary to be segregated for such term as the court may impose at such hospital, 
sanitarium or clinic. ( Illinois Revised Statutes, chap. 23, sec. 363.) 

In practice this statute means that women who have not even been 
convicted of the violation of any law are, merely on suspicion, subjected 
to the unspeakable indignity, degradation, and torture of a compulsory 
examination. If found to have such a disease a sentence of compulsory 
hospitalization is imposed. The men who are the companions of these 
unfortunate women are in practice treated very differently. It is true 
. that the word “persons” and not “women” is used in the law, but in 
Illinois, as in other communities where such laws have been passed, in 
practice it is regularly enforced, as it is meant to be enforced, against 
women alone. The law was passed in 1919, and in April, 1922, the 


6 


Chicago press announced as a sensational piece of news (see newspapers 
of April 15, 1922) that for the first time one of these sentences had been 
imposed on a man. That is, during the three years from 1919 to 1922 
although the law said “persons,” this provision had apparently never 
been in fact invoked against a man, whereas hundreds of women had 
undergone this humiliation. The present Commissioner of Health un¬ 
doubtedly believes that the law is being used fairly in Chicago against 
both men and women, but we have good reason to believe that he is 
greatly deceived in this matter. He alone does not enforce the law. It 
is in the hands of the courts as well. And we have reason to believe 
that it is only the women and not the men who are subjected to this 
examination before any evidence has been heard by the court against 
them, and that it is only the women who are actually under detention for 
long periods of time. On this point your Committee wishes to quote and 
commend the words of Mr. Abraham Flexner: 

Prostitution must be punished if at all, because its consequences are bad, 
because of the waste it involves, the disease it spreads, the demoralization it entails. 

Yet so long as the woman alone suffers, these consequences are not abated. 

Punishment of the woman in any particular case stops none of these; the man 
simply wastes his substance upon others; contracts disease from other women and 
carries it elsewhere, even into his own family; corrupts others, in case a previous 
associate has been put out of reach by the law. To make prostitution a crime for 
the woman alone is therefore at once inequitable and futile. It is likewise becoming 
progressively more difficult. As long as societies were organized on the theory of 
the male superiority, the woman could perhaps be singled out to bear alone the 
burden of a dual offense. But that day is past. Theoretically, the equal ethical 
responsibility of both sexes in every relation in life is already recognized; it is 
rapidly becoming incorporated in law .... The stigma and consequence of 
crime must therefore be either removed from the woman or affixed to the man. 

The essential viciousness of the present system. —-The present system 
is objectionable because it leads to the continuation of the outlawed houses 
instead of to their abolition; it involves the use of the “raid,” an un- 
American policy, which we unqualifiedly condemn; it involves also the 
degradation of the officials who enforce the law through the unlimited 
possibilities of corruption and “graft”; and it leads to the deterioration 
of public morals through the publication of sensational accounts of these 
activities in our press. Finally, the present system is based on a policy 
of discrimination against women. For, however fair-spoken the statutes 
may be in seeming to punish equally men and women who are equally 
guilty, or however good the intentions of our health officers may be in 
desiring to avoid discrimination against women—in practice it is impos¬ 
sible to enforce such laws in a fair way, and wherever such laws exist 
they are in fact enforced against women alone. We again urge the 
repeal of section 363, chapter 23, which by permitting forcible examina¬ 
tion before trial virtually provides for the punishment of women before 
they are found guilty of any offense. 

The futile system of “ raiding” by the police. —The raid is a sensa¬ 
tional, violent, and un-American method of law enforcement. It belongs 
more properly to the dark days of the Russian autocracy than to the 
twentieth century in America. A body or “squad” of police are rushed 
to the suspected places in patrol wagons; the various exits and entrances 
are guarded while the inmates are “rounded up.” And while a neigh¬ 
borhood crowd of men, women, and children gather to look on, the 
inmates are forcibly conducted to the police stations. Later, the womep 


7 



are taken to the Health Department for a compulsory examination; and 
they are then held by the police until the results of the examinations are 
available, when they are taken to court. The “raid,” which is spectacular 
enough to blind the public into thinking that something is being done, 
is a futile method of dealing with this problem. A few houses are 
“raided” while others are left free to operate. And the “raided” houses 
frequently open again “for business” with new recruits within an hour 
after the police and patrol have left. A few women and girls are held 
in jail while the others, who if not already infected will soon become 
infected, are left free to take their places. 

Women offenders should be in the custody of women police. —If a 
woman or a girl is to be arrested she should at least be taken into custody 
decently and quietly by a woman police officer, taken to a proper House 
of Detention for Women, 'placed in the hands of women social service 
workers, and given a chance to free herself from the slavery of her old 
life, to listen to “the faint voice of her better self.” 

Every prostitute is a woman in chains. Our Chicago Vice Com¬ 
mission in 1911 showed clearly that these unfortunate women are the 
miserable victims of a hideous system of commercialized vice that is too 
often protected for corrupt purposes. This whole system has been thor¬ 
oughly exposed in Chicago not only by the official Vice Commission but 
also by the numerous reform organizations working in this field. Women 
have a heavy responsibility here, for public morals can only be protected 
by good government. Organized vice has been one of the heaviest con¬ 
tributors to corrupt political funds. With the corruption of government 
goes the corruption of public morals. Now that women have votes, the 
obligation lies heavy upon us to see that our administrative officials, even 
if moved by the best intentions, do not adopt policies that tend to per¬ 
petuate this infamous and degrading system. 

Persecution of prostitutes not only unjust but futile. —We object to 
these measures, therefore, for many reasons, because, even prostitutes, 
poor and with no friends to see justice done, should surely be given fair 
treatment in our American courts instead of being punished before they 
are tried, while the men who have also been guilty escape. Our whole 
policy is that of persecuting the 'prostitute. In the old days she was fined 
and went back to ply her old trade. Today, she is arrested, compulsorily 
examined, and held in detention for treatment. In either case she shortly 
returns again to her old life, and the whole wretched business begins 
over again. The system is condemned by its obvious futility. “What 
can it avail,” asks Mr. Abraham Flexner, 

to incarcerate for brief periods a few unhappy women, if meanwhile the manufacture 
of fresh foci of infection proceeds unhampered? As long as regulation completely 
omits men, new sources of infection are produced far more rapidly than by any 
known method they can be eradicated. A vicious circle exists. Men infect the 
beginners—themselves at the time out of reach—who in their turn infect other 

men.Prostitution is a concept involving two persons. Logic and justice 

alike require that both parties be considered as equal partners in the act; and in no 
respect is it more completely impossible to omit either of the two essential factors 
from the reckoning than in the matter of disease. Society has chosen to overlook 
the man; but nature has righted the balance by impartially distributing disease and 
suffering; nor will she permit herself to be outwitted by any one-sided scheme, even 
though it be far more extensive and efficient than regulation has thus far anywhere 
been. 


8 



Powers of health officers over contagious diseases. —We also find 
it necessary to call attention to certain methods that have recently been 
applied in the administration of the law dealing with the control of con¬ 
tagious diseases. This law gives the health officers very wide powers in 
the matter of isolating, quarantining, and placarding all cases of dan¬ 
gerous communicable disease. No one will deny the necessity of granting 
such powers to the health officials, but it is a fundamental principle that 
they should be uniform in their application. It is often said that there 
is no difference in the treatment of scarlet fever and the treatment of 
venereal disease, that both must be quarantined and the places in which 
they are found placarded. Although this sounds plausible, it is clear 
that there are very wide differences between the two. Every case of 
scarlet fever is supposedly known and placarded, whether the patient is 
rich or poor, a man or a woman. In the case of venereal disease only a 
very small proportion of cases are ever reported or known, and apparently 
the only ones that are ever placarded'—and these are not quarantined, they 
are only placarded—are occasional cases in houses of prostitution. If 
scarlet fever and smallpox were not placarded, we would have no way 
of protecting ourselves from the contagion. People do not wantonly 
expose themselves to the dangers of these diseases. But it is a tragedy 
of our civilization that men do wantonly expose themselves to the venereal 
diseases. They know that by avoiding immorality they may escape con¬ 
tagion. Placarding is not necessary. More than that,'—it is also futile 
and dangerous. For even the occasional placarding of places in which 
venereal disease has been found inspires confidence that the health officials 
are really quarantining all infectious places and leads to a false sense 
of security. The “house” that is not “placarded” is believed to be “safe,” 
whereas it may become infected at any hour, at any moment. The 
woman who is not infected when one “raid” occurs may become infected 
long before another “raid” is made. 

The city ordinances of Chicago and the orders of the State Board 
of Health show clearly the difference between venereal and other conta¬ 
gious diseases. Our Chicago ordinance making venereal disease report- 
able clearly says (1193b) that “the name and address of such diseased 
person shall not be reported to the Department of Health.” A regulation 
of August 1, 1918, issued by the State Board of Health, makes venereal 
diseases reportable but provides that the name of the diseased person is 
to be omitted if such person is not a prostitute, an associate of a prosti¬ 
tute, is not in the military or naval service and gives assurance that he 
will take treatment and follow the instructions of the physicians. 

The names and addresses of persons having smallpox and scarlet 
fever are not withheld from the Health Department. They are all re¬ 
ported so that every case may be quarantined. It is clear that the purpose 
of withholding names is to prevent the Health Department from quaran¬ 
tining the persons infected. Can anyone believe that the spasmodic 
quarantining of an occasional prostitute is a scientific proceeding in the 
name of public health. As a well-known authority (Hooker, The Laws 
of Sex) has pointed out the infected man who may later transmit disease 
to his innocent wife and children is a much more dangerous person from 
the standpoint of racial infection and is in much greater need of being 
quarantined if anyone is to be quarantined, than an occasional prostitute. 


9 


All these measures, which are really measures for the oppression 
and persecution of prostitutes, are objectionable for many reasons, but 
most of all they are objectionable because they are futile. Nothing could 
be more ineffective than a system of quarantine dealing only with women, 
or only with prostitutes. Statistics already quoted (see p. 4) from the 
records of our Illinois clinics show a much larger number of cases of 
venereal disease among men than among women. And the prostitute class 
includes only a fraction of the women infected with such diseases. 

In testifying recently before a Parliamentary Committee in Great 
Britain, the Undersecretary of State for War said that the testimony of 
doctors had indicated that from 72 to 75 per cent of venereal disease 
came from the non-professional class. Similarly, Sir Archdall Reid in 
an article in the Nineteenth Century , August, 1921, said, “three out of 
four soldiers now acquire their infections from amateurs.” And he 
added, “Evidently prostitutes only hang on the fringe” of current im¬ 
morality. 

Measures that merely punish the prostitute and then restore her to 
her trade have been abundantly experimented with in the past, and they 
have led to nothing but the continuation of venereal disease and the 
degradation of public morals. 

Let us not deceive ourselves by the noise and clamor of raids into 
thinking that we are really doing anything to abolish either prostitution 
or venereal disease. Dealing with the prostitute clearly means dealing 
only with what Sir Archdall Reid called “the fringe” of current immor¬ 
ality. 

Moreover, we should never lose sight of the fact that whenever a 
health officer knows of the existence of a house of prostitution whether 
venereal disease is present or not, it is his duty to report the fact to a 
law-enforcing officer and have it closed instead of having the inmates 
examined and placing a placard on the door. 

SOME FACTS ABOUT WHICH THE PUBLIC IS MISINFORMED 

Exaggerated reports concerning the prevalence of venereal disease.— 
Your Committee thinks it well to call attention to the fact that the reports 
of the extent of venereal disease are frequently grossly exaggerated. 
Wide publicity has been given in the press and elsewhere to a statement 
that five out of eight men under twenty-eight years of age, that is, approxi¬ 
mately 63 per cent, are infected with a venereal disease. (See Chicago 
press, Tuesday, October 31, 1922.) This terrible statement if true would 
indeed be an indictment of our civilization. Fortunately, an author¬ 
itative basis now exists which utterly disproves such loose and reckless 
estimates. The monumental report issued from the United States War 
Department by Surgeon-General Ireland and his assistants on Defects 
found in Drafted Men (Washington, Government Printing Office, 1920) 
gives an authoritative statement as to the extent of venereal disease 
found among the second million registrants examined. The report 
showed that instead of more than sixty in a hundred, fewer than six 
men in a hundred were infected with any kind of venereal disease. In 
the Southern States the ratios ran higher. Thus in Florida, Georgia, 


10 


Mississippi, South Carolina, Louisiana, Alabama, and Arkansas, the 
rates ranged from ten to sixteen per hundred men. On the other hand 
in many states the rate was less than two in a hundred men. These 
states were New Hampshire and Vermont, Utah, North and South 
Dakota. And, in nineteen states, less than three in a hundred were 
infected. In Illinois the rate was 5.3 in a hundred. Making all due 
allowance for the fact that methods of diagnosis may not have been 
adequate to detect some of the less obvious cases, still the Surgeon- 
Gieneral’s return of less than 6 per cent and the statements quoting more 
than 60 per cent are so wide apart that it is not surprising that the 
Surgeon-General noted in his report that “the total amount of venereal 
disease found is much less than many of the propagandists in the field 
of sex hygiene have asserted to be present in our population of young 
unmarried males” (p. 78). 

We do not wish to minimize in any way the seriousness of an 
infection of 5 per cent, and we hope that every possible effort will be 
made to reach and to cure those who are suffering; but we believe that 
the Surgeon-General’s statistics do show that there is no occasion for 
panic propaganda. Nor is there any reason for the adoption of hasty, 
doubtful, or ill-considered measures in a field where it is so easy to do 
more harm than good. 

The development of moral standards versus regulation. —Another 
false contention is the claim that venereal disease continues to exist 
because in the past the only attempts to prevent it have been “along 
moral and educational lines.” This is a statement that is very wide of 
the truth. As a matter of fact, in the past the moral and educational 
sides have been greatly neglected. The “abolitionist” laws have been 
only half-heartedly enforced, and until recently it was common for local 
authorities to tolerate vice, the “segregated district,” and all the evils 
connected with it. The insistence on moral teaching is not old; it is 
new. The system that has failed is the old system of segregation and 
toleration. 

Failure of “ regulation ” in England. —After a long history of “regu¬ 
lation” on a national scale in England, going back to the so-called 
Contagious Diseases Acts of 1864, 1866, and 1869, it was learned that 
the compulsory examination and detention of prostitutes led nowhere. 
The determined opposition, under the leadership of Josephine Butler, 
of the women of England to this degrading system led to the abolition 
in 1883 of the compulsory examination of women and in 1886 to the 
complete repeal of the Acts. These Acts were supposed by their authors 
to be necessary for the protection of the health of the men in the British 
Army. But time has proved that the better way of protecting their 
health was a method that also protected their morals. In 1886, when 
the Contagious Diseases Acts were abolished, the army returns for 
venereal disease showed a rate of 267 per 1,000 men, and this rate had 
fallen to 158 in 1896, to 81.8 in 1906, and to 50.9 in 1913. 

A recent authoritative verdict against regulation came from the 
British Royal Commission on Venereal Disease, which issued its final 
report in 1916. This Commission, which was composed of twelve men 
and three women with Lord Sydenham as chairman and which included 


11 


in its membership such distinguished medical men as Sir John Collie. 
Sir Arthur Newsholme, and Sir Malcolm Alexander Morris, made a 
clear statement in their report as to the futility of the system of ‘"regu¬ 
lation,” and they reported that they wished to “place on record their 
view that the evidence which they have received, which includes that of 
several continental experts, points to the conclusion that no advantage 
would accrue from a return to the system of those Acts. So far from 
this being the case,” they added, “it is to be noted that the great improve¬ 
ment as regards venereal disease in the Navy and Army has taken place 
since the repeal of the Acts” (Final Report, 1916, p. 2). And the 
report of the Commission also states, emphatically, “If venereal diseases 
are to be stamped out, it will be necessary not only to provide the medical 
means of combating them, but to raise the moral standards and practice 
of the community as a whole” (Final Report, p. 60). 

Failure of regulation on the Continent. —'The policy of “regulation,” 
compulsory examination, registration, and control of prostitutes has 
been tried for more than a hundred years in Europe; and we have 
only to turn to Mr. Flexner’s account of this policy to see how com¬ 
pletely it has failed. Mr. Flexner reported that regulation as a system 
not only ran “counter to the modern spirit in ethics, in politics, and in 
hygiene,” it was, he said, “positively harmful in its bearing on disease.” 
Regulation he found had actually been 

a factor in perpetuating the conditions out of which it sprang. The existence of 
regulation amounts to a concession by the state that a vast volume of promiscuous 
intercourse is to be accepted as a fact; that for this purpose professional prostitution 

is recognized and, despite verbal quibbles, authorized.The prominence thus 

given to immorality operates psychologically as an incitement to it. The complacent 
attitude towards indulgence implied in the mild effort made by the state to remove 

or reduce its dangers indubitably diminishes internal inhibition.. Nothing 

is more certain in the domain of effort and ethics than that good conduct is largely 
the response of the individual to the expectation of society: men “can because they 
think they can.” Social stigma is a most powerful deterrent; social assent a power¬ 
ful stimulus. Regulation implies the absence of any expectation of self-restraint; 
it is society’s tacit assent to laxity. Nay more, it is an invitation to laxity in so 
far as it deprives dissipation of one of its terrors, for the existence of medical 
regulation must be interpreted as implying a certain degree of efficacy in the attain¬ 
ment of its object. There can, therefore, be no question that state regulation of 
vice increases the volume of irregular intercourse and the number of those who 
participate in it. Certain it is that the notion that male self-control is both possible 
and wholesome has spread “pari passu” with the attack on regulation and with the 
elevation of the status of woman that invariably accompanies this movement.— 

(Prostitution in Europe, p. 218). 

The War responsible for a new interest in the maintenance of moral 
standards. —A new interest and a new concern over the maintenance of 
moral standards was felt by the men and the women of this country 
during the war. Every American woman may be justly proud of the 
fact that in the very beginning of our participation in the war our 
government adopted the theory that its young soldiers should be kept 
not only physically fit but morally fit. The program of the Commission 
on Training Camp Activities to provide recreational and educational 
facilities for the leisure hours of the soldiers received enthusiastic en¬ 
dorsement throughout the country. Public opinion quickly supported 
a plan for abolishing segregated districts and immoral houses instead 
of the hideous policy of examining and supervising prostitutes. 


12 





The relatives and friends of our young soldiers demanded that they 
should be returned to their homes not only free from physical disease 
but free from moral contagion. This is and should be the American 
policy, and the women’s organizations in this city and state should guard 
it jealously against the encroachments of those who hastily rush forward 
with measures which threaten to undermine the moral standards of the 
community. Let us never deviate from the principle that prostitution 
can and must be abolished, and let us refuse to make any compromise 
with those who support the old, hated, and discredited principle that 
vice is necessary and can be made safe. 

The hideous “prophylactic packet” system. —Unfortunately, however, 
the war was responsible for the spread of a great deal of misinformation 
about the so-called “prophylactic packet” system. Extravagant claims 
have been made as to the success of this system among the units in which 
it was used, and some public health officials have been demanding since 
the close of the war that the system be adopted for wide-spread use 
among the civil population. There are two questions to be raised here: 
First, Was the system successful as a war measure? Second, Is it 
suitable for use among the civilian population? 

Fortunately, an authoritative answer to both of these questions has 
been furnished in two official British “white papers” both of which were 
issued after the war. The first of these is a “Report of the Interdepart¬ 
mental Committee on Infectious Diseases in Connection with Demobilisa¬ 
tion” (Lord Astor, Chairman) to the Ministry of Health on “Prophy¬ 
laxis Against Venereal Disease” (Parliamentary Papers of 1919, Cmd. 
322) ; and the second is a “Statement Made by the Ministry of Health, 
with Concurrence of the War Office, Relative to Incidence of Venereal 
Disease amongst Soldiers, etc.” (Parliamentary Papers of 1920, Cmd. 
505). The history and conclusions of the Astor report may be briefly 
stated. When a proposal wa!s made in Great Britain that the public 
authorities should provide packets before exposure to infection as a 
possible method of preventing the spread of venereal disease during 
demobilization, the British Association for Moral and Social Hygiene, 
of which Dr. Helen Wilson is chairman and Mrs. Fawcett and Miss 
Maude Royden, Dr. Scott Lidgett, the Dean of Lincoln, Sir Charles 
Tarringy J. P., and Mr. Lees-Smith, M. P., and Dr. Douglas White 
are among the vice-chairmen, strongly protested against the adoption of 
this system on the ground that experience during the war had made it 
clear that the policy was “subversive of good morals” and tended “to 
increase promiscuity and therefore venereal disease.” That is, the Asso¬ 
ciation for Moral and Social Hygiene took the 'position that the system 
had not succeeded in making vice safe, that it had had the terrible 
result of creating a tragic illusion of security just as the old systems 
of regulation did, with a consequent increase in exposures and a result¬ 
ing increase in venereal disease. Above all, it was pointed out, the 
system inevitably led to the moral degradation of those for whom it was 
provided. 

In the face of the opposition aroused, action was postponed until 
after Lord Astor’s committee could make a searching investigation of 
the question whether special encouragement • should be “given officially 
by the government to the sale of packets, i. e., the provision before 


13 


exposure to infection, of means of prophylaxis for application or use 
by the individual, whether before or after such exposure.” As to the 
use of the system during the war, the evidence collected by the committee 
showed that the highest venereal disease rates in the British forces were 
the rates for the Australian forces in spite of the fact that the Australians 
had the most complete prophylactic system that had been developed. 
“The system organized by the Australian forces was most thorough,” 
says the report. “Men were almost individually instructed, and packets 
were handed with full directions to men going on leave. Theoretically,” 
said the committee, “it should have reduced the venereal rate to negligible 
proportions.” As a matter of fact, however, when the venereal disease 
rates for all British troops in the United Kingdom ranged from 36 to 
43 per thousand in 1917-1918, the rates for the Australian troops ranged 
from 132 to 176. 

The committee stated further that they held the evidence was not 
sufficient to prove that such methods met with success in the army use 
of them aside from certain exceptional individual cases. The committee 
said positively that among the troops “which during the war employed 
the prophylactic packet system most energetically no proportionate reduc¬ 
tion was brought about in the infection rate.” 

Further statements as to the war experience are made in the “white 
paper” of 1920 in which it is shown that there were numerous cases of 
soldiers suffering from venereal disease in hospitals who had used the 
packet system with tragic consequences. On the basis of statistics from 
several British Military Hospitals presented in this white paper, it is 
stated emphatically that the evidence showed that venereal disease was 
by no means prevented “when the disinfectant is applied by the man 
himself; and this even when he has been in a military unit under military 
discipline and has been furnished with the usual lectures and posters 
together with personal instructions.” 

It may be well to quote also a statement on this subject made by 
Lord Sandhurst in the House of Lords, December 10, 1919: 

It has been frankly asserted.that if only the civil population were 

instructed to use proper disinfecting drugs.immediately after exposure to 

infection, and if outfits for this purpose were made generally available, the risk of 
venereal disease would be avoided; and that, if this policy were made general by 
the Government, the disease would before long disappear. But careful investigation 
has conclusively shown that even amongst the military, where disciplinary arrange¬ 
ments can be resorted to and instruction can definitely be given, there are found 
amongst soldiers in venereal disease hospitals substantial numbers of men who state 
categorically that they used permanganate of potassium within a few minutes after 
exposure. It is thus clear that even in circumstances especially favourable to in¬ 
struction and to the method proposed, the risk of venereal disease is by no means 
certainly avoided; for even in those conditions a certain number of cases occur. 
How much more then would this be the case, and how far removed should we still 
be from secured immunity, with the civil population, in respect of whom the arrange¬ 
ments as to instruction and discipline adopted for the military would obviously be 
quite impossible ( Hansard, column 877; December 10, 1919). 

As to the moral aspect of the use of this system even among the 
military and naval forces, our Secretary of the Navy, Mr. Daniels, wrote 
to all commanding officers in 1915 : 

The spectacle of an officer or hospital steward calling up boys in their teens 
as they are going on leave and handing them these “preventive packets” is abhor- 


14 




rent to me. It is equivalent to the government advising these boys that it is right 
for them to indulge in an evil which perverts their morals. I would not permit a 
youth in whom I was interested to enlist in a service that would thus give virtual 
approval to disobeying the teachings of his parents and the dictates of the highest 
moral code. You may say that the ideal raised is too high, and we need not expect 
young men to live up to the ideal of continence. If so, I cannot agree. It is a duty 
we cannot shirk to point to the true ideal—to chastity, to the single standard of 
morals for men and women. (Quoted in Hooker, The Laws of Sex, p. 260.) 

Testimony as regards the -American army was presented to the 
Astor Committee by Colonel Whaley and Major Skelton of the U. S. 
Army Medical Corps. These officers said: 

Relative to the issue of medicaments for prophylactic treatment before exposure 
to risk of infection: The American Army does not issue for use, nor encourage 

the use of any medicaments or any other protective method before exposure. 

When prophylaxis was first instituted in the American Army, individual prophylactic 
tubes.were issued to enlisted men going to nearby towns from their garri¬ 

son or camp. Public sentiment, on the ground that such issue was morally wrong 
and tended to be suggestive, forced the army authorities to abandon the issue. 

Colonel Whaley in answer to questions stated that the system of 
issuing packets before exposure had been a failure in the American army 
and he was 

strongly of opinion that for the civil population good- propaganda and centres 
for proper treatment would be of considerable value, but he was decidedly not in 

favour of the issue of packets for self-disinfection.He was of the opinion 

that every effort should be made to promote morality among men, and to do away 
with the arbitrary differences of moral standard which existed between girls and 
young men in the same class of life (Cmd. 322, p. 21). 

Further, as to the proposed extension of the prophylactic packet 
system to the British civil population the Astor Committee reported that 
as a result of examining the evidence secured from a large group of 
distinguished medical men and army officers, their conclusion was that 
prophylaxis methods would be much more difficult to apply to a civil 
population than to an army under military discipline. 

They further stated it as their opinion that “energy should not he 
dissipated on measures of doubtful value, but concentrated rather on 
wise propaganda and the provision of early, prompt, and skilled treat¬ 
ment, in order to diminish the prevalence of these diseases!’ Finally 
the committee stated emphatically that the “true safeguard against these 
diseases is individual continence and a high standard of moral life. This 
implies a sound public opinion and a healthy national tone.” The com¬ 
mittee also added that they had set out to examine the evidence placed 
before them from the scientific and the medical point of view, and it is 
strictly in this spirit that they desire to record it as their opinion that 
“the irreplaceable effect of the moral factor has been too frequently 
neglected or forgotten.” 


Your Committee apologizes for dealing in some detail with this mat¬ 
ter of “prophylaxis,” but it is a subject on which women have been asking 
for information. We believe the evidence clearly shows that the system 
is a failure as a public health measure. More than this, it is clear that 
the system, if adopted, will imperil the morals of the youth of the com¬ 
munity, that it will impede the efforts to abolish prostitution and make 
more difficult the attempts to establish a higher standard of public morals. 


15 




We may, in fact, say of this latest proposal to tolerate and condone 
an evil that ought to) be abolished, as Mr. Abraham Flexner said of 
the general European system of toleration and regulation, that the first 

and weightiest objection to it is “not that it fails as hygiene. 

but that it obstructs and confounds the proper attitude of society toward 
all social evils, of which prostitution is one.” 

Fundamental preventive measures. —A further point should be in¬ 
sisted on, that is, that certain fundamental social reforms are necessary 
to protect the morals and health of the youth of our community. The 
problem of prostitution is not only a moral problem, it is also a problem 
of poverty and ignorance and exploitation. Such constructive measures 
are needed as the abolition of child labor, the extension of compulsory 
education, the enlarged provision by the community of facilities for decent 
recreation as a substitute for commercialized methods of recreation that 
too often make the path to destruction easy for the youth of the com¬ 
munity to* follow. We believe also in the necessity of improving living 
and working conditions and providing adequate wages for women and 
girls. We were told nearly two thousand years ago that “the wages of 
sin is death,” but we know also that, too often, “the wages of virtue is 
dust,” and we urge the women of Illinois to consider carefully the pro¬ 
posed minimum wage law as one means of strengthening the wage-earning 
girl against temptation. 

The moral issue. —Finally, we do not wish to overlook the fact that 
women have been charged with being “sentimentalists” in this matter 
because they believe in the value and virtue of moral teaching. We are 
not afraid of this charge. Nor are we ashamed of believing that decent 
standards of morality must be expected of men as well as of women. 
We are accused of believing in “exhortation and advice,” and we do 
believe in both. However, it should not be overlooked that women are 
not alone in valuing moral standards. Secretary Daniels in his abhor¬ 
rence of a system that threatened to undermine the moral ideals of the 
young, Lord Kitchener in his fine and moving appeal to the British expe¬ 
ditionary forces, and the vast majority of our own army officers were 
also sentimentalists when they insisted on the maintenance of good morals 
as well as good health among their men. 

On this point, we especially commend the statement made in the 
recently issued Fourth Annual Report of the Illinois State Department 
of Health (Social Hygiene Division) as to the importance of that educa¬ 
tion which helps “to guide the activities of individuals toward a right 
standard of conduct. In other words education must aim at developing 

the self-control necessary.and at inculcating sound principles of 

social morality,” and again this report emphasizes that “instruction should 
be based on moral principles and spiritual considerations and should not 
be based only on the physical consequences of immoral conduct.” Finally, 
the report adds with “firm conviction,” that “permanent and lasting 
benefits in the control of venereal diseases can accrue only through 
educational measures, no matter how important treatment and suppressive 
measures may be.” (p. T41). 


16 





recommendations 

A brief summary of suggestions as to what the women of Illinois 
may do: 

1. Co-operate with your local officials to secure the establishment in 
your community jointly with the Social Hygiene Division of the State 
Health Department of one or more free clinics to provide competent treat¬ 
ment for those suffering from venereal disease. 

2. If such a clinic already exists in your community, co-operate 
with your local officials in helping them to maintain the highest possible 
standards. In particular, try to secure a special waiting room for women, 
a woman doctor, a nurse, and a social service worker. 

3. Urge your representative in the State Legislature to support an 
increase in the appropriation for the support of these clinics during the 
next biennium. 

4. Co-operate with your local hospital authorities in seeing that 
provision is made for the free voluntary care of those who have no 
homes in which they can remain while out of work. Try to assist the 
authorities in providing a social worker for these hospital cases. 

5. In large cities the women’s clubs could meet an urgent need by 
establishing a boarding home or hostel for unfortunate girls who are only 
clinical cases but have no proper place to stay while under treatment. 

6. Insist that in your locality the city and state’s attorneys enforce 
the law abolishing houses of prostitution. 

7. Whenever prostitutes must be taken into custody insist that 
women, police officers be detailed for this service. 

8. Insist that the men who are the associates of these women also 
be taken into custody and that the keepers and owners of such houses be 
vigorously prosecuted according to the law. 

9. Urge your representative in the Legislature to support the pro¬ 
posed repeal of Section 363, chap. 23, Revised Statutes, on the ground 
that it cannot be enforced without discriminating against women. 

10. Urge the City Council of Chicago to make an adequate appro¬ 
priation for the support of women police officers. An effort should also 
be made to secure a more effective organization of the women police 
through the establishment of a separate division. Experience has shown 
that such women can do much to protect public morals and to prevent 
young girls and young men from taking the first steps on downward 
paths. Women police are as greatly needed in the small towns as in the 
large cities, and the women’s organizations in every community should 
insist on the appointment of at least one woman on the police force. 

11. Investigate the conditions under which women offenders are 
held in your local police stations, county jails, or city workhouses. The 
vast majority of women offenders are young girls who are charged with 
some form of immorality. The conditions of their imprisonment at 
present seldom help to restore them to decent lives and do much to con¬ 
firm them in their evil habits of living. 


17 


12. Study the recommendations regarding the proper treatment of 
women offenders in the Cook County Jail Survey recently issued by the 
Chicago Community Trust (copies may be secured from the offices of the 
Trust, 10 South La Salle Street). This section of the report should have 
the vigorous support of every woman in Chicago who has any civic or 
humanitarian interests. 

13. Join in a state-wide movement of women to demand a legisla¬ 
tive appropriation for the farm colony for women offenders. The Legis¬ 
lature of 1919 passed a law establishing a farm colony for women, but 
the law remains a dead letter because no appropriation has ever been 
made for this urgently needed institution. 

14. Above all, remain staunch at all times to the “abolitionist” prin¬ 
ciples which women have so often successfully defended in the past. 
Make no compromise with those who believe that vice should be officially 
condoned or “regulated.” Their counsel is a heart-breaking counsel of 
despair which will lead only to degradation in every community that 
accepts it. 

(Signed) Edith Abbott, Chairman 
Jessie F. Binford 
Adena Miller Rich 
Jean Leslie Stephens 

Committee 

Chicago, November, 1922. 





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